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Trucking job Application

Secure Trucking Job Application

Please fill in all of the requested data and click Submit below.
* are the only required fields - but - the more data you can give the carrier the better your chances.

*Zip Code
*Best Phone (xxx-xxx-xxxx)
(not required but highly recommended)
*Date of Birth (xx/xx/xx)
*Social Security Number (xxx-xx-xxxx)

*Application Type (if unsure, choose Company Driver)
License Number
License Expiration (xx/xx/xx)
License State
*License Class
(Important: select all that apply)

(Important: select all that apply)

*Years of Driving Experience
Driving School Graduate?
*Number of Moving Violations (last three years)
*Number of Accidents (last three years)

Employer Name
Phone Number
Address, City, State, Zip
Starting Date
Ending Date

Employer Name
Phone Number
Address, City, State, Zip
Starting Date
Ending Date

*Felony Convictions (last five years)
*DUI/DWI Convictions (last five years)
*License Suspensions (last five years)
Your comments:
(Use this to describe what you're looking for or to explain any negative items above. However, keep it brief and do NOT paste anything into this field as it may interfere with a carrier receiving your application)
I prefer to drive (Select all that apply using CTRL + Click)

By submitting this application, I give permission for companies to order MVR, DAC Reports, and do a Background Check using my social security number. I also certify that I personally completed this application and that all of the information is true and correct. I hereby request and authorize any company that receives this application to investigate my background for employment purposes, which may include but will not be limited to any information relating to my character, reputation, criminal history, past work experience, educational background, alcohol or drug test results or failure to submit to an alcohol or drug test or any other information about me which may reflect upon my potential for employment gathered from any source which may have knowledge concerning such items of information, and that I hereby give consent in accordance with any and all FCC regulations for companies to contact me via the cellular or landline telephone number I have provided, either through live or autodialed and prerecorded means, text or email concerning this information or any available employment opportunities. I further certify that I have completed this application of my own free will and hold and Rodgers Media LLC harmless from any and all liability for providing this application for my use and for distributing my information to prospective companies.

Please click the Submit button only once and allow time for the application to process.